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Sask. physicians urged to make practices accessible to people with disabilities

Saskatchewan’s physicians take the issue of accessibility for patients with disabilities seriously, says Saskatchewan Medical Association president Dr. Joanne Sivertson.

"Physicians are in the business of providing care, and clearly we cannot fulfil our duty if patients cannot access that care,” said Dr. Sivertson. "The SMA has begun discussing ways that we can assist our members in providing better access to care within their offices."

Last year the Health Ministry asked the College of Physicians and Surgeons of Saskatchewan (CPSS) to help spread the message to doctors about how they can accommodate patients with disabilities. The Ministry of Health surveyed regional health authorities on the accessibility of their facilities, not only physical access from outside, but the equipment inside such as examination tables.

Times have changed

Jennifer Cohen, a Regina woman who uses a wheelchair, says the medical profession has not done enough to make practices accessible to people with disabilities.

“Get with modern times” is her message to Saskatchewan’s physicians. “We need medical care like anybody else and they’re not providing it…”

Cohen cannot get onto a physician’s table unless it is adjustable. Her family physician is in a clinic that has other disciplines such as physiotherapy. When she makes an appointment she has access to an adjustable table, but it isn’t a physician’s table.

“Other disciplines seem to think they need them whereas some doctors don’t seem to think this is an issue,” she said.

Doctors have a role

Dr. Sivertson said at minimum, physicians should make arrangements for patients to receive care where their needs can be met.

“It should not fall on the shoulders of a patient to find these locations themselves,” she said. "While a single office may not be able to offer access for all manner of disabilities, as a system we can work together to ensure appropriate services are provided."

Judith Ryan, a woman who is paraplegic and uses a wheelchair, from Saskatoon, had to navigate through the health system on her own to find a gynecologist who had a bed that could accommodate her disability. Her family physician did not have the proper equipment to perform a Pap smear. She eventually heard about a female gynecologist at the Women’s Health Centre in City Hospital who had access to the right equipment to do the procedure, and received a referral from her family physician.

“My concern is how many disabled women aren’t getting the kind of gynecological care they should get because they don’t have access to accessible beds and assistance, and generally I have concerns about the type of medical care, especially preventative care, that people who use wheelchairs are getting.”

Cohen says she won’t go to a health-care facility without phoning ahead to see if it has a hoist or a Hoyer lift.

“I have phoned clinics when they’ve sent bulletins around saying they are accepting new patients, so I phone and say, ‘Do you have any adjustable exam tables?’ ” she said, adding none that she has contacted do.

“To the doctors of Saskatchewan I say please consider people with mobility limitations and how they can provide a medical service to us.”

According to the 2012 Canadian Survey on Disability, almost 15 per cent of Saskatchewan’s population aged 15 years or older reported having a disability that limited their daily activities.

“What I would like doctors to see is that it is an issue that affects more than a few people, it affects a lot of people,” Ryan said.

Her hope is that physicians take the lead in developing alternatives, such as working with health officials to establish health centres that would have all of the lifts and equipment needed to fully treat people with disabilities.

Raising awareness, finding solutions

Bryan Salte, associate registrar with College of Physicians and Surgeons of Saskatchewan, says the college has been trying to raise awareness among physicians.

“The point we are encouraging physicians to do is to turn their minds to the question of how is it that they are able to accommodate patients who have a variety of different needs?” he said. “When somebody comes in and says, ‘I can’t get onto the examination table,’ have they addressed that in advance?

“Physicians at the very least have to be in a position to consider what they might be able to offer and how they might offer it.”

According to the Provincial Disability Strategy, released in June 2015, anyone who operates a service has an obligation to make reasonable accommodations for people with disabilities.

Using the example of an examination table, a doctor might meet requirements by arranging with health authorities to have an adjustable examination table available, Salte says.

“You’re always looking at that question of what is a reasonable accommodation in order to deal with the needs of patients, and if you don’t do that you have failed in your human rights obligation.”